The specific aim of this project is to explore and promote the application of graphic computer simulations in the domain of clinical medicine. This will occur initially through the incremental development of a critical mass of practical stand- alone simulation systems, with a focus on providing for the needs of medical education. An ongoing effort will be made to identify those areas of clinical medicine most likely to benefit from the application of simulation technology. Methods of integrating these systems with each other and of providing communications with other types of computer applications will be investigated. Experience gained from prototype simulation-based tutoring systems has identified four highly interdependent, yet distinct subprojects: 1) The creation of a comprehensive library of simulation-based applications, which will serve to attract student and physician users, providing the source of feedback needed for the incremental development of these systems, 2) The development of human-machine interfaces that will derive from and support the unique cognitive tasks of physicians and medical students, 3) The development of appropriate tutorial strategies, compatible with the problem-solving experience and motivation of discovery learning fostered by these simulation environments, to provide users with instructionally effective advice, and 4) Establishing a standard communications protocol to provide for information sharing both between simulation systems and between simulations and other types of applications. The formative evaluation of this project will rely heavily on feedback from medical student and physician users. This feedback will be utilized to determine the direction of further efforts within these subprojects, and to identify those areas of clinical medicine in which graphic simulation methods can be applied most effectively. A comprehensive summative evaluation, performed with the aid of an educational psychologist and other specialists, will be used to determine the effectiveness of the overall tutorial strategy employed by each application.